Balda, Thomas J

Balda, Thomas J is an individual health care provider with primary practice located at 950 W Main St Suite 125, Lake Zurich IL 60047. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Balda, Thomas J can be contacted via phone (847) 726-2020.

Contact Information

Primary practice address
950 W Main St Suite 125 Lake Zurich IL 60047
Phone: (847) 726-2020
Fax: (847) 726-2036
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 046008673 Illinois

Profile Details

NPI number 1396820858
LBN Legal business name Balda, Thomas J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2006
Last updated May 13th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396820858 NPPES
Illinois MEDICAID 046008673

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